Background. Immediate postpartum intrauterine contraceptive device (IPPIUCD) is a lucrative postpartum family planning method which provides effective reversible contraception to women in the delivery setting. Our aim was to study the clinical outcomes of IPPIUCD insertions and compare them as a factor of route of insertion (vaginal versus caesarean). Methods. This is a retrospective analytical study done in a tertiary care teaching institute. A Cohort of 593 vaginal and caesarean deliveries with IPPIUCD insertions, over a two-year period, was studied and compared for follow-up results. Outcome measures were safety (perforation, irregular bleeding, unusual vaginal discharge, and infection), efficacy (pregnancy, expulsions, and discontinuations), and incidence of undescended IUCD strings. Descriptives were calculated for various outcomes and chi square tests were used for comparison in between categorical variables. Results. Overall complication rates were low. No case of perforation or pregnancy was reported. Spontaneous expulsions were present in 5.3% cases and were significantly higher in vaginal insertions (p = 0.042). The incidence of undescended strings was high (38%), with highly significant difference between both groups (p = 0.000). Conclusion. IPPIUCD is a strong weapon in the family planning armoury and should be encouraged in both vaginal and caesarean deliveries. Early follow-up should be encouraged to detect expulsions and tackle common problems.
Background: The purpose of this study was to determine the compliance of the pregnant women and factors related to iron tablet consumption behavior among pregnant women. Response to iron deficiency anemia is related to the dose and schedule of a iron tablets and diet. Noncompliance reduces treatment benefits and is associated with poorer prognosis. Methods: A detailed questionnaire designed to assess the antenatal women compliance. Eight hundred and sixty women of 16-30 wks pregnancy who received iron tablets daily for 90 consecutive days in Rohtak city of Haryana state. Results: The results showed that compliance among pregnant women, regarding iron supplementation, was observed by 80.47% women, non compliance was observed by 14.42 % while over compliance was observed only by 5.11% women. Compliance was better observed in educated patients as compared to uneducated i.e.62.14% versus 37.86%. The reasons for non compliance were side effects 29.03% , suffering from pregnancy complications and taking multiple drug supplements 22.58% , long term taking of iron tablets 19.35%, not liking pharmaceutical preparations 16.94%, forgetfullness 9.68% and not liking due to poor quality of iron tablet supplied by government were 2.42%. Almost all the women believed that the doctor, pharmacist and nurse explained the instructions for intake of iron tablets and diet to them and they followed those instructions. Conclusion: This study shows that compliance is related to education of the pregnant women and proper explanation of instructions by doctor, pharmacist and nurses, help to improve the compliance but much can be done to improve existing iron supplementation programs in developing countries by ensuring that iron tablets of good quality are available at all levels of health care.
INTRODUCTION:The present study was performed to assess the safety and feasibility of a new laparoscopic entry site in cases suspected of adhesions due to previous surgery.MATERIALS AND METHODS:It is a retrospective study undertaken at a tertiary care referral center for advanced gynecological laparoscopic surgery from January 2011 to December 2014.RESULTS:In 624 patients with a history of previous abdominal surgeries, the laparoscopic entry site was through a newly devised point. It is a point in the left paraumbilical region at the level of umbilicus, in a straight line drawn vertically upward from a point 2.5 cm medial to anterior superior iliac spine. Intra-abdominal adhesions were found in 487 (78.0%) patients, and umbilical adhesions in 404 (64.7%) patients with past abdominal surgeries.CONCLUSION:There were no significant entry-related, intra-operative, or postoperative complications with the use of this entry point. It is also suitable as a main working port during the course of surgery.
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